Plans are in the pipeline to revamp mental health services in West Cumbria – which could include the closure of a ward at Whitehaven’s West Cumberland Hospital.
Bosses at the health trust, responsible for mental health services across the county, say the 16-bed Yewdale ward is no longer fit for purpose.
In documents shared to staff and seen by Cumbria Crack, the Cumbria, Northumberland, Tyne & Wear NHS Foundation Trust said it was embarking on an engagement plan about mental health services in Cumbria.
While they say no decisions have yet been made, including the future of Yewdale ward – and people are urged to share their views about mental health services – it said concerns have been raised for many years about the ability to provide high quality care in West Cumbria.
Discussions have been taking place for around 12 months about the long-term future of mental health care.
It said the overall quality of the hospital estate and geography of inpatient services, specifically Carlisle to Whitehaven, have been long-standing challenges.
Discussions have started about Yewdale ward’s future and the trust said feedback will be collated in January, and then used to inform future plans for adult acute mental health inpatient services in West Cumbria.
James Duncan, chief executive of the trust, said: “No decisions have been made yet about changes to Yewdale ward. Decisions will be guided by our desire to deliver the best care and support that we can, with the resources we have available.
“Our priority is to do everything we can to make services in West Cumbria better for those who need them. We need to start by recognising the quality and safety issues we face today, and the opportunity to deliver better mental health support for the communities that we serve over the coming years.
“We want to do this in collaboration with our staff, service users, carers, stakeholders and local people, to help us shape the future of mental health services in Cumbria to be the very best they can be.
“This is why we are encouraging people to visit our website to learn more about the challenges facing these services, and seek their views: https://www.cntw.nhs.uk/news/we-want-your-thoughts-on-mental-health-services-in-cumbria/
“We’ll also be sharing details soon about some listening events in West Cumbria and Carlisle, which we invite everyone to come along to.”
The hub will provide four short-stay beds for people in crisis.
The trust said the vast majority of people in receipt of mental health care within north Cumbria receive services from community services. Last month, 8,812 north Cumbrian residents were treated by community services, and 96 by inpatient services.
The trust operates Yewdale ward, with 16 mixed-gender beds and Carlisle’s Carleton Clinic, which has 10 male beds and 10 female beds. There is also a trust-wide psychiatric intensive care facility in Sunderland.
The trust said it had invested in the Carleton Clinic, which will see an increase in beds from 20 to 32.
Currently, Yewdale ward has 14 patients.
The trust said that was an 87.5% occupancy rate; all 14 patients on the ward are from north Cumbria. Since April, 24% of north Cumbria residents requiring an adult acute admission, were admitted into Yewdale ward, with 76% of Cumbria patients admitted into other wards across the trust.
The trust said it had seen a ‘steady reduction’ in out of area beds being used over the past 12 months and has now reached a consistent position of zero inappropriate ‘out of area’ placements.
An inappropriate out of area treatment is considered to be when an individual is admitted to a unit that does not form part of the usual local network of services – in Cumbria’s instance, the usual network includes Northumberland and Tyne & Wear as the mental health trust runs services across the entire region.
What is wrong with Yewdale ward now?
The trust says:
- Yewdale ward is ‘isolated’ – around 40 miles from the ‘main hospital’ site. It says: “Its location also means it lacks the wider immediate support that a comparable ward on a main psychiatric hospital site would be able to draw upon and in the event of an incident or issue with staffing.”
- There are significant challenges with staffing. It adds: “Particularly, from a consultant psychiatric provision which has been an issue for over 20 years.”
- Mixed sex ward – Concerns over sexual safety
- Deteriorating building – the hospital is run by a different trust – the North Cumbria Integrated Care NHS Trust. The mental health trust says: “There are currently a number of outstanding estates issues, which still require urgent attention. These have continually proved to be a challenge in terms of priority for completion, and the standard of work undertaken.”
It added: “The experience reported by service users remains a concern, as currently they are unable to meet in person with the responsible clinician in charge of their care.
“Agency health care assistant staffing is often used due to limitations of attracting staff, this can have a significant impact on the quality and experience of services being provided.”
Why can’t Yewdale ward be revamped?
The trust says there are several reasons why this is not an option.
- The building is not owned by the mental health trust.
- Nationally, regionally and locally, there is limited access to capital – building and maintaining estate.
- Addressing the environmental issues would not address the safety and quality issues of the service and the issue of Yewdale being an isolated ward.
- It would not address the staffing recruitment challenges in the area.
What will happen to people already in Yewdale ward?
The trust said: “Appropriate engagement and discussions will be undertaken with all patients, and carers, currently on Yewdale ward, who would be directly affected by any future proposals to change services.
“For example, then as part of the further engagement process, all patients on the ward at the time will be fully assessed, and those ready for discharge will be done so appropriately.
“However, for those patients still requiring inpatient treatment, the bed management team and ward staff will look to transfer those patients to other wards within the locality, or if more appropriate and safe to do so, back to their own locality, for those who do not normally reside in the Cumbria area.”
Why is the trust looking at mental health services?
In 2024, the national inpatient quality programme was launched which sets out requirements for mental health inpatient services for the future.
The programme has five objectives:
- Localising and realigning inpatient services, harnessing the potential of people and communities.
- Improving the culture of care and supporting staff.
- Supporting systems and providers facing immediate challenges.
- Making oversight and support arrangements fit for the sector.
- Support leady coercive care through reducing restrictive practices.
This includes moving away from isolated units, offering real alternatives to admission, and ensuring a clear therapeutic offer is in place when people need to come into hospital for their care, the trust said.
It added: “We recognise that improving community services, including crisis services is essential for West Cumbria and the new hub offers a real opportunity to realise the national ambitions for community and inpatient care.
“However, the trust also recognises the engagement and open communication which is needed with the local community in relation to what this means for the future of Yewdale Ward, which is not sustainable.”
What does the MP say?
Josh MacAlister, Whitehaven & Workington MP said: “Mental health services in West Cumbria need to be significantly improved.
“I have spoken twice with the CEO of the mental health trust and I have been clear that any changes to Yewdale ward must result in a better service for patients.
“I am yet to see any detailed plans which give me confidence that the proposed closure would improve services. Unless the trust can convince me and the community that changes will improve access to mental health services for West Cumbrians I will oppose the closure.”
How can you tell the trust what you think?
To help the trust shape its plans, it wants to hear people’s thoughts on mental health services in Cumbria.
